Managing atopic dermatitis with antioxidant treatment emollients: A narrative review and consensus statements

Atopic dermatitis (AD) is a common inflammatory skin condition that can profoundly impact patients' quality of life. In Asia, AD is highly prevalent, and misperceptions of AD among the public and phobias of topical corticosteroid (TCS) treatments and the region's humid climate pose challenges to adherence. Emollients - moisturizing agents that hydrate the skin and improve its barrier function - are a core component of therapy for AD. This manuscript summarizes expert consensus from a group of Hong Kong experts on clinical management of AD, focusing on the role of emollients, and discusses if the term "treatment emollients" - emollients formulated with active non-drug disease-targeting ingredients such as antioxidants - could be helpful for communication and clinical practice. Summary statements, based on a literature review, were developed at an expert meeting and evaluated using a Delphi process. Treatment emollients have antioxidant or other disease-targeting ingredients that may provide additional therapeutic benefit in beyond moisturization alone. Emerging clinical data suggest that a treatment emollient containing the antioxidant furfuryl palmitate could improve AD symptoms and patients' quality of life. Such an agent has a potential role at various stages in the AD disease journey and may complement other therapies, such as TCSs or systemic therapies. The definition of the treatment emollient may evolve as additional examples with other therapeutic benefits (e.g., anti-inflammatory or antimicrobial effects) are developed. Treatment emollients represent a valuable additional option for AD patients, and they may be particularly useful where steroid phobia is prevalent.